Task Force Helps Haiti Overcome Challenges to the ‘Last Mile’ of Lymphatic Filariasis Elimination

A disfiguring neglected tropical disease called lymphatic filariasis (LF) may soon be eliminated from Haiti, but determining if elimination has been reached remains an ongoing challenge that The Task Force is trying to help address.

LF is no longer endemic in much of Haiti after a number of years of mass drug administration (MDA). Efforts have now shifted to determining whether the prevalence levels are low enough that the disease is no longer a public health problem.

In August, The Task Force began a multi-country study in Haiti to assess the sensitivity of the transmission assessment survey (TAS) that is normally used to determine when it is safe to stop MDA and conduct surveillance. Katie Gass, PhD, MPH, an epidemiologist at The Task Force’s Neglected Tropical Diseases Support Center, traveled to the commune of Limbe in the northern part of the country, which had undergone MDA from 2009-14. A 2015 TAS of school-age children indicated that LF was no longer a public health problem in Limbe, but concerns were raised about whether LF transmission was still taking place within the population.

While in Limbe, Gass worked with partners from the Centers for Disease Control and Prevention, IMA World Health, and the Ministry of Public Health and Population to test children and a sampling of adults for LF infection. The results of the survey will help Haiti determine whether LF transmission has been interrupted in the area or if more MDA is needed.

“Haiti is getting close to eliminating lymphatic filariasis – a particularly impressive feat given all the obstacles the Ministry of Health has faced, from natural disasters to disease outbreaks,” said Gass. “We’re helping in the last mile of elimination by developing tools to make sure that it is safe to stop treating the population and that the disease is unlikely to come back on its own.”

Data from the research in Haiti, and similar studies also led by The Task Force in Tanzania and American Samoa, may help inform the development of a new enhanced TAS tool for the World Health Organization (WHO) and the Global Program to Eliminate Lymphatic Filariasis. Such a tool would improve countries’ abilities to confirm that LF has been eliminated and accelerate progress toward WHO’s goal of eliminating LF as a public health problem globally by 2020.

Photo caption: Task Force epidemiologist Katie Gass (right) confers with Dieulove Charles, a resident of Limbe, Haiti, about lymphedema in her leg, which could indicate lymphatic filariasis infection.

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